Podiatry Arena members do not see these ads

I was recently flipping through the sunday paper when i discovered an advertisment for "THE ROBERT CHARLES CLINIC" which claimed to realign patients legs and treat the cause of their problems.
I thought that it was an advertisment for a Podiatry Clinic, but i scanned the page and realised that the practitioner had an exercise science degree. I thought that seemed a bit strange so i went to the web page www.trcc.com.au and found that the guy makes orthotics for people, and basically slams the podiatric proffession for prescribing 'plastic orthotics'.
If this guy claims to be a clinical biomechanist, shouldnt he have a masters in his degree as well?

It doesnt seem to add up to me.

So he is expanding to Brisbane. RC is based in SA and has been active in Vic for a number of years and is just another competitor for podiatrists. If he is having to go as far afield as Qld for business that might say something :)

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Stephen Tucker
Eastern Health
Podiatry Manager

My location

Since when did you need a podiatric degree to dispense orthotics?

you don't. Im simply saying that i think you need a little more than a 3 year exercise sports science degree before you start bagging the podiatric proffession. You also need a masters degree in biomechanics before you can call yourself a biomechanist.

I always find it laughable when anyone chooses to "bag" orthotics made by another group, when its obvious they are totally unfamiliar those types of orthotics. A superficial read of the website above shows the person in question has no idea what "podiatric orthoses" are (whatever they are!) ... funny how he chooses to "bag" something he knows so little about. How many times have we seen this before? I ask, where is his evidence? We can certainly roll out numerous RCT's, outcome studies, and patient satisfaction studies on "podiatric orthoses" that show they work, so I guess he is spreading BS on his site.

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Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia
http://www.latrobe.edu.au/podiatry
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God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University
This is where I am, where are you?

Netizens

Foot paraphalia is classed as a commody and there is no restriction on who can sell them to the general public. Money back guarentees if not completely satisfied will meet most fair trade regulations.

Bagging other groups is also a common convention in modern advertising, seen too with politicians unwilling to make comment on a concrete matter will take a swipe at the opposition to detract the public's attention. Most discerning consumers take this type of advertising with a pinch of salt.

Expanding sales to other areas may have no significance other than the operation is expanding its market because it can now deal with greater demand.

Something which may come as a surprise (nothing to do with the topic per se)is many podiatrists will use regularly shore orthotic services because they are cheaper and considered better quality than local manufacturers. That is the way of the world.

Cameron

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Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen

We don't need to consult an exercise physiologist to undertake a exercise program & we don't need to consult a GP to self-prescribe a whole host of drugs... but are these professionals unworthy - of course not. Those who 'bag' another, harbour doubts about their own worth.

Lots of practitioners of many modalities prescribe foot orthotics as a clinical tool, however always remember the tools of the trade are not the trade itself.

The difference with RC is that i think he has a provider number, hence pt's are able to claim from their health benefits. I know this was the case in SA a few years ago. Whether it still is, I'm not sure.

I was prescribed orthotics by a specialist in another field from podiatrists. Scans were taken of my feet using a computer sensing device which printed a diagram on paper which was sent to a lab overseas and the orthotics made up and posted back. Costs were over $400 and despite the orthotics feeling comfortable to wear over a period of time I began to experience pain in my legs from knees down, the longer one more so. Unfortunately for me the orthotics were not diagnosed as being the cause of the pain. After a year or so and visits to doctors no results until I was recommended to a long standing podiatrist who diagnosed that the orthotics were the cause of the problem as they were not providing the proper support for my feet, were mass produced and in fact due to their softness were flattening out when pressure was applied. New conventional orthotics fixed the problem fairly quickly. Various claims had been made about how good the original orthotics were.I think orthotics should only be prescribed by podiatrists who specialise in that field rather than allowing any 5 minute expert to prescribe them and then not have the experience or skills to support the patient.

Hi John,

It's the educated design application of an orthotic with an educated diagnosis and review program that assists with positive outcomes...

it's not the orthotic.......

Your case is so common - you have experienced what many patients I consult have in the past.

interesting remarks...
A certain sports footwear and clothing company in australia is currnetly releasing into its stores a computer system whereby shoe salesman can scan feet and prescribe CUSTM insoles to customers. They are charging $240.00 I believe. This is very concerning to me. How can a shoe salesman have the knowledge to do this? What happens when things go horribly wrong? These devices should be regarded as medical appliances.... not footwear!

Have you seen them? Plastic template shells - must be able $5 to produce. Therefore the other $235 is for the 'technology' - pressure mapping at it's most basic, and the expertise of the prescibing practitioner (oopps, sorry - the teenager working retail part-time).

Where does that leave the patient??

But what are we as a profession doing to support our well founded belief that what we have to offer is superior? Having worked in the footwear industry (in footwear fitting training and other sundry exercises), I met an awful lot of shoe retailers who really did not know what podiatrists were up to. The typical questions they asked me were:

Why are your orthotics so very much more expensive than others - they essentially look the same?
(Well, if you don't have explained to you what goes into the prescriptions and manufacture and dispensing of orthotics, how can they know by just gazing upon the end product?)

Why do you tell patients to come and buy shoes which do not actually exist? Why do you not warn patients that their orthotics will only fit into butt-ugly shoes?
(Hey, you might have warned them, but the frustrated patient who can't find shoes they like will take it out on the retailer. And let's face it, the 'ideal' shoe for women still doesn't exist in a consumer friendly form).

And so on and so forth. When I took the time to explain to them what we are trying to do (and these people were very open and willing to understand as much biomechanics as I could feed them), they were very grateful.

Now, extrapolate this to the whole population. We spend a great deal of time in our own milieu trying to explain and justify what we do. But if you are a punter who doesn't know any better - time and convenience and cost will be powerful factors influencing your choice as to who gives you orthotics! Add to that the fact that our 'competition' is willing to make claims of certainty that we as professionals refuse to, and you can see what is happening.

What we need is a couple of significant figures (Prime Ministers, Presidents, Royalty, Paris Hilton...) to be saved by our fair hands, and we will have our advertising and endorsement problems solved!

Hi

An earlier poster made this comment:

What happens when things go horribly wrong?

It would be interesting to to see if we could define:

a. what we mean by "horribly wrong"
b. any examples of such cases, albeit anecdotal - indeed if any at all (thinking here of FFO for feet as opposed to AFO issues)

We often use the idea of horrily wrong in defence of our role but what proportion of devices issued by none trained people can we say actually go horribly wrong.

Ian

As much as it pains me to say it....if anything I would have to say custom made devices from pods are more likely to go horribly wrong. Sure, your over the counter vasyli might not treat any given condition as well as a custom made device, but i can't recall many that actually caused pain. Where as there are plenty of custom made devices sitting in a cupboard somewhere because they "hurt" to wear. I know which one the client is going to think went horribly wrong.

Not sure if it is the same chain as mentioned above, but i know the store in our area is pushing everyone into a pair of over the counter orthotics to go with the purchase of a pair of shoes. It amazes me how many people go with it too.

Cheers


Tom

I was doing exactly this for 15 yrs (before doing the pod degree) in the snow skiing and bushwalking industry. Make and fit "footbeds" NOT orthoses in order to make people more comfortable doing the activities they enjoy. The end user is usually more than capable of deciding if they help or not...it's not rocket science. It's not so wrong a thing to do...and a lot of customers are very happy with the results.
Can some one explain why we seem to want to "medicalize" everything? except that it is in the interests of the proffession to do so....make money with less competition?
Is what we do so different?...other than that we like to tell ourselves that we are better at it?......that's why I did the degree....to be better at it....all these other people in other professions are just raising community awareness about this stuff....they are just warming up "my" future customers.....the ones with real problems will finally discover some who can do the more complicated stuff......and it might be me.....I just want to sell them their last pair of orthoses....not necessarily the first pair....word of mouth will do the rest in the long run.
regards Phill Carter

Lets translate this into physio and chiro terms.

I bet that no physical therapist who uses solely electrotherapy (interferential/ultrasound/tens) has ever made a patient worse.

I bet that no chiropractor who has used a 'clicker' has ever made a patient worse.

But how many have they made significantly better?


Ultra conservative therapy won't get horrible results. Bit like staying inside your home to make sure you never get hit by a car.


Mechanical problems have mechanical solutions. Mechanical therapy is mostly about working out which forces are beneficial and which ones are detrimental.

In 2100, despite a century of RCT's and countless books and DVDs and seminars, trial and error will still have a significant role. If you are not prepared to take a 1/4 of a step back on the odd occasion, it will be pretty difficult to take 1 step forward consistently.



Ron